RSA-227 - Annual Client Assistance Program (CAP) Report

Idaho (DisAbility Rights Idaho, Inc.) - H161A140059 - FY2014

General Information

Designated Agency Identification

NameDisability Rights Idaho, Inc.
Address4477 Emerald Street
Address Line 2Suite B-100
CityBoise
StateIdaho
Zip Code83706
E-mail Addressinfo@disabilityrightsidaho.org
Website Addresshttp://disabilityrightsidaho.org
Phone208-336-5353
TTY 208-336-5353
Toll-free Phone866-262-3462
Toll-free TTY866-262-3462
Fax208-336-5396

Operating Agency (if different from Designated Agency)

NameDisability Rights Idaho, Inc.
Address4477 Emerald Street
Address Line 2Suite B-100
CityBoise
Zip Code83706
E-mail Addressinfo@disabilityrightsidaho.org
Website Addresshttp://disabilityrightsidaho.org
Phone208-336-5353
TTY208-336-5353
Toll-free Phone866-262-3462
Toll-free TTY866-262-3462
Fax208-336-5396

Additional Information

Name of CAP Director/CoordinatorDina M. Flores-Brewer
Person to contact regarding reportDina M. Flores-Brewer
Contact Person Phone208-336-5353

Part I. Agency Workload Data

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the Rehabilitation Act10
2. Information regarding Title I of the ADA0
3. Other information provided5
4. Total I&R services provided (Lines A1+A2+A3)15
5. Individuals attending trainings by CAP staff (approximate)63

B. Individuals served

An individual is counted only once during a fiscal year. Multiple counts are not permitted for Lines B1-B3.

1. Individuals who are still being served as of October 1 (carryover from prior year)6
2. Additional individuals who were served during the year25
3. Total individuals served (Lines B1+B2)31
4. Individuals (from Line B3) who had multiple case files opened/closed this year. (In unusual situations, an individual may have more than one case file opened/closed during a fiscal year. This number is not added to the total in Line B3 above.)1

C. Individual still being served as of September 30

Carryover to next year. This total may not exceed Line I.B3. 6

D. Reasons for closing individuals' case files

Choose one primary reason for closing each case file. There may be more case files than the total number of individuals served to account for those unusual situations, referred to in Line I.B4, when an individual had multiple case files closed during the year.

1. All issues resolved in individual's favor7
2. Some issues resolved in individual's favor (when there are multiple issues)4
3. CAP determines VR agency position/decision was appropriate for the individual0
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)3
5. Individual chose alternative representation0
6. Individual decided not to pursue resolution6
7. Appeals were unsuccessful2
8. CAP services not needed due to individual's death, relocation, etc.0
9. Individual refused to cooperate with CAP4
10. CAP unable to take case due to lack of resources0
11. Other (please explain)

N/A

E. Results achieved for individuals

1. Controlling law/policy explained to individual11
2. Application for services completed.0
3. Eligibility determination expedited1
4. Individual participated in evaluation1
5. IPE developed/implemented0
6. Communication re-established between individual and other party3
7. Individual assigned to new counselor/office0
8. Alternative resources identified for individual2
9. ADA/504/EEO/OCR/ complaint made0
10. Other8
11. Other (please explain)

Complaint withdrawn due to lack of cooperation, client withdrew complaint due to employment or did not wish to pursue resolution.

Part II. Program Data

A. Age

As of the beginning of the fiscal year. Multiple responses are not permitted.

1. 21 and under0
2. 22 - 405
3. 41 - 6425
4. 65 and over1
5. Total (Sum of Lines A1 through A4. Total must equal Line I.B3.)31

B. Gender

Multiple responses not permitted.

1. Female12
2. Male19
3. Total (Sum of Lines B1 and B2. Total must equal Line I.B3.)31

C. Race/ethnicity

1. Hispanic/Latino of any race2
For individuals who are non-Hispanic/Latino only
2. American Indian or Alaskan Native3
3. Asian0
4. Black or African American0
5. Native Hawaiian or Other Pacific Islander1
6. White25
7. Two or more races0
8. Race/ethnicity unknown0

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Blindness (both eyes)1
2. Other visual impairments1
3. Deafness0
4. Hard of hearing0
5. Deaf-blind0
6. Orthopedic impairments10
7. Absense of extremities0
8. Mental illness12
9. Substance abuse (alcohol or drugs)0
10. Mental retardation2
11. Specific learning disabilities (SLD)0
12. Neurological disorders2
13. Respiratory disorders0
14. Heart and other circulatory conditions0
15. Digestive disorders0
16. Genitourinary conditions0
17. Speech Impairments0
18. AIDS/HIV positive0
19. Traumatic brain injury (TBI)2
20. All other disabilities1
21. Disabilities not known0
22. Total (Sum of Lines D1 through D21. Total must equal Line I. B3.)31

E. Types of individuals served

Multiple responses permitted.

1. Applicants of VR Program12
2. Clients of VR Program15
3. Applicants or clients of IL Program3
4. Applicants or clients of other programs and projects funded under the Act1

F. Source of individual's concern

Multiple responses permitted.

1. VR agency only27
2. Other Rehabilitation Act sources only2
3. Both VR agency and other Rehabilitation Act sources2
4. Employer0

G. Problem areas

Multiple responses permitted.

1. Individual requests information1
2. Communication problems between individual and counselor6
3. Conflict about services to be provided10
4. Related to application/eligibility process12
5. Related to IPE development/implementation2
6. Other Rehabilitation Act-related problems0
7. Non-Rehabilitation Act related1
8. Related to Title I of the ADA0

H. Types of CAP services provided

Choose one primary CAP service provided for each case file/service record.

1. Information/referral3
2. Advisory/interpretational17
3. Negotiation2
4. Administrative/informal review4
5. Alternative dispute resolution0
6. Formal appeal/fair hearing0
7. Legal remedy0
8. Transportation0

Part III. Narrative

Narrative

CAP FY2014 PPR - Draft

PART III — NARRATIVE:

a. Type of agency used to administer CAP:

External — Protection and Advocacy agency

b. Sources of funds expended: Source of Funding Total expenditures spent on individuals Federal Funds $97,907 State Funds 0 All other Funds 0 Total from all Sources $97,907

c. Budget for current and following fiscal year. CATEGORY CURRENT FY (2014) NEXT FY (2015) Wages/ salaries $47,482 $74,686 Fringe Benefits 27,877 32,954 Materials/Supplies 3,723 4,616 Postage 419 574 Telephone 574 976 Rent 6,218 7,462 Travel 3,720 3,636 Copying 1,345 670 Bonding/insurance 708 837 Equipment 0 0 Legal services 0 0 Indirect costs 0 0 Miscellaneous 5,840 8,448 Total (from all sources)97,907 13,4859

NOTE: 2014 Actual Expenses includes carryover from FY13 (10/1/12 - 9/30/13) 2015 Budget includes projected carryover from FY14 (10/1/13 - 9/30/14) d. Number of person-years:

Position Type FTE % of yr.filled Person/Years Professional 0.85 89.39% 0.70 Full-time NA NA NA Part-time 0.85 89.39% 0.70 Vacant 1.17 9.72% 0.11 Clerical 0.28 80.00% 1.13 Full-time NA NA NA Part-time 0.28 80.00% 1.13 Vacant 1.00 8.33% 0.08

e. Summary of Presentations Made:

1. P&A staff conducted presentations about the CAP program/process for approximately 48 Vocational Rehabilitation staff and customers at 3 different offices, including during VR orientation. A computerized CAP orientation CD was created and provided to local IDVR offices to show clients during weekly client orientation meetings. Additional CDs are being created and will be disseminated to IDVR offices statewide to provide verbal/visual information about the CAP program and how to request CAP services. 2. Two transitional planning presentations, including information about the CAP program, were provided to approximately 34 Century High School transition age students and their parents. Students were informed about the transition process, including VR’s involvement, and other requirements of a transition plan. 3. Tools for Life Transition Conference: P&A staff conducted 5 presentations at the Tools for Life Transition Conference in Idaho Falls, ID. Approximately 300 transition age students and their parents attended the conference. Topics presented by P&A staff included workshops on Transitioning from School to Work, Work Incentives, Self-Advocacy, Guardianships, and Voting Rights. Individual workshop attendance ranged from 8 individuals to 22 individuals. 4. CAP Training to Idaho Commission for the Blind and Visually Impaired (ICBVI)/Independent Living Center staff: Advocate met and provided information about the CAP program to the Independent Living Services coordinator and two staff with the ICBVI. Independent living services were discussed, as well as the CAP process. A possible systemic issue was identified: that the ICBVI/ILC staff indicated they do not write plans for clients; and clients are asked to sign a waiver on a routine basis. Large print CAP brochures were requested and will be provided. 5. Treasure Valley Deaf Forum: Training on employment rights and CAP services were provided to approximately 65 people at the Deaf Forum, in collaboration with the NW ADA Task Force and the Treasure Valley Deaf Association. Two P&A staff (Senior Advocate and Staff Attorney) participated in the planning committee for approximately 6 months for the event. 6. Employment Discrimination/Rights training for Treasure Valley Multiple Sclerosis Society in Meridian, ID: CAP Director provided training to approximately 50 members of the Treasure Valley MS Society at St. Luke’s Hospital in Meridian, ID. Topic focused on Title I of the ADA, and included information about the CAP program and general P&A system, and brief information on the VR and ILC programs. 7. P&A staff training: training on CAP was provided to DRI staff. Topics included details about the CAP process, eligibility, the vocational rehabilitation and independent living center systems, and employment rights/discrimination. 12 staff attended 8. DRI completed 13 different trainings in which we trained approximately 197 people, including approximately 87 transition age youth, on Voter Rights and accessible options. A portion of the trainings also focused on information about what the P&A does under other grants, with a focus on the P&As employment services grants (CAP, PABSS, and WIPA).

f. Involvement with Advisory Boards: 1. State Rehabilitation Council: CAP is represented on the State Rehabilitation Council (SRC) by the CAP Director. The SRC reviews IDVR policies and provides IDVR with suggestions and recommendations to ensure policies meet the requirements of the Rehabilitation Act. Most meetings also have members of the public present, airing concerns they have with the IDVR system; CAP typically provides information and referral to these individuals, some of whom have contacted CAP for case follow up. CAP is also a member of the SRC membership committee. The focus this year including increased focus on transition age youth and the changes required under WIOA. 2. Idaho State Department of Education Special Education Advisory Panel: CAP is represented on the Idaho State Department of Education Special Education Advisory Panel (SEAP) by one staff member. The SEAP is an advisory panel of parents and staff from education and related agencies, including IDVR, and includes secondary transition as one of its three designated focus areas. 3. Idaho Interagency Council on Secondary Transition: CAP is represented on the IICST, a collective group of organizations brought together through funding provided by the Idaho Department of Education for the purpose of improving transition services for youth and improving secondary education and employment outcomes. CAP provides input on its role in facilitating services from agencies funded by RSA for transition age youth, as well as participating in the organization of the annual Tools for Life Conference for transition age youth. P&A has been asked to provide staff to facilitate transition conference sponsored by State Department of Education and NSTTAC next fiscal year (November, 2014). 4. Traumatic Brain Injury Advisory Council: CAP is represented on the State Traumatic Brain Injury Advisory Council (TBIAC). The Idaho TBIAC is mandated by the TBI State Grant. CAP staff provides input into employment related issues/services as needed by individuals with traumatic brain injury. 5. Idaho Employment First Consortium: CAP is represented on the Idaho Employment First Consortium by one staff. The initiative, which began in 2012, focuses on changing policies and practices throughout Idaho to ensure that all people with disabilities who are able to work, have the opportunity to work, and that competitive, integrated employment is the first consideration for transition age youth and adults with disabilities. The past year’s work included collaborating with Medicaid to ensure community supported employment is being provided to adults on the DD and A&D waivers, monitoring issues with IDVR that create barriers to employment, and partnering with Idaho Department of Labor Disability Employment Initiative Grant to provide information encouraging employment for people with disabilities. The focus during the next year will be getting Governor’s office buy-in on an executive order promoting employment first. CAP is also a member of the Work Incentives Work Group, a subcommittee of the Consortium with the focus of ensuring Idahoans receive consistent, quality information about work incentives, encouraging them to enter the work force. The Consortium also provides employment related recommendations to the Adult DD Community Work Group (see below). 6. Adult Developmental Disabilities Services Community Work Group: CAP was represented by the P&A Executive Director. The Community Work Group is comprised of representatives of state agencies such as Medicaid and IDVR, as well as service providers, consumers, and other disability related agencies. Its purpose is to provide guidance and specific recommendations on redesigning Medicaid services for adults with DD. 7. Deaf Forum Planning Committee: Two staff (Senior Advocate & Staff Attorney) participated in 2-3 hour monthly planning meetings for the Deaf Forum Event held in September in the Treasure Valley. Committee consisted of 6-10 people from Treasure Valley Deaf Association, Idaho Council for the Deaf and Hard of Hearing, Northwest ADA Task Force and P&A. Focus of training will be rights of individuals who are deaf or hard of hearing, to include presentations from P&A on employment rights and services. 8. Self Advocate Leadership Network: P&A staff is an ex-officio member of the SALN advisory board/executive committee. SALN is an organization established under the umbrella of the Idaho Council on Developmental Disabilities, consisting of adults with developmental disabilities who are self advocates, and provide mentorship to other adults in self-advocacy.

g. Outreach to Unserved and Underserved Populations:

1. Outreach CD to local IDVR offices for CAP orientation to IDVR customers; additional CDs will be provided to IDVR offices statewide, with an ILC CD to follow. This will allow for CAP outreach to all VR/ILC offices, including those located in rural parts of the state. 2. Refugee Conference — Boise State University: Outreach provided to approximately 100 refugees attending an informational conference sponsored by Boise State University and the Idaho Office for Refugees. Information was provided on general P&A services, the CAP program, and other employment services programs. 3. Tools for Life Conference — Idaho Falls, ID: Outreach information provided to transition age youth and their parents. Approximately 300 youth and parents were in attendance. Information focused on transition/employment rights, self-advocacy and other information on transitioning from high school to adulthood. 4. Hailey Transition Fair — Blaine County School District: Outreach was provided to approximately 55 transition age youth, parents and school staff. Brochures on CAP, PABSS and WIPA were handed out. 5. Outreach to Employment Networks/Sheltered Workshops — outreach conducted to 3 ENs/Sheltered workshops located in north Idaho and southwest Idaho. Brochures and information was provided to approximately 20 individuals and staff. 6. Veterans Welcome Home Event — Boise VA Medical Center: Information about the P&A and CAP was provided to veterans at the annual Vets Welcome Home Event sponsored by the Veterans Administration and held on the grounds of the VA Medical Center in Boise. Approximately 55 visitors to the booth, including veterans and their families, VA organizations and community providers. 7. Other outreach events: a. Boise Community Progressive Fair: Booth at Community Progressive Resources Fair at Julia Davis Park. About 20 people in attendance. b. Advocacy Day at the Capitol: Booth for Advocacy Day at the Capitol in the Capitol Building in Boise. Information was provided to groups of people with disabilities, their families, community members and Idaho Legislators. 8. Brochure distribution: CAP General: 5045 CAP Large Print: 196 CAP Spanish: 21 CAP Braille: 2

h. Alternative Dispute Resolutions:

The CAP did not participate in alternative dispute resolution. All issues were resolved through less formal interventions.

i. Systemic Advocacy:

1. Confusion between Idaho Division of Vocational Rehabilitation Referral Form and Application Form: Clients have long complained to CAP and IDVR about the confusion between the Referral Form required by IDVR and the actual Application Form that triggers the IDVR application timeline and process. The Referral Form requested full information from the IDVR applicant, including medical information, past employment history, education history, etc. The form was approximately 20 pages when complete, and was required to be completed and submitted before IDVR would initiate contact to start application process. The application itself was approximately 2 pages, and mostly was informational, along with the required notifications as well as the required signature pages for the applicant and VR counselor. CAP Director and a Senior Advocate attended an IDVR Public Forum (see below) in February, and brought up the issue as one that needed resolution. In July, IDVR issued new forms, with the new Referral Form asking for basic referral information, and the application/intake form containing the bulk of information necessary to initiate VR services. Clients have the option of completing the application/intake form prior to meeting with their counselor, or may wait to meet with their counselor to get assistance in completing the form. 2. IDVR Public Forum: P&A staff participated in the IDVR Public Forum which was held to discuss upcoming issues and changes within IDVR. Meeting included local region VR counselors and managers, in addition to the interim director and the Chief of Field Services. Members from the State Independent Living Council staff were also in attendance. In addition to the referral/application form issue discussed above, we discussed concerns about the wait list for Extended Employment Supports and the availability of Medicaid Home and Community Based Waiver Services for the Aged & Disabled (A&D Waiver) to help pay for long term services once IDVR finished the development piece. 3. Meetings with IDVR Administrator and Chief of Field Services: The CAP Director continues to meet quarterly with both the IDVR Acting Administrator (who recently was named IDVR Administrator) and the Chief of Field Services to discuss systemic issues. These discussions led to the change in the Referral vs. Application forms, and open lines of communication between IDVR and the CAP. 4. Nez Perce Tribal Vocational Rehabilitation Services Policy Manual: A systemic issue was identified last year in that the Nez Perce VR Services program did not have a complete policy manual to guide the provision of services, resulting in issues of confusion about what services were to be provided and when. CAP communicated our concerns to the Program Administrator, and after several conversations over several months, the Nez Perce VR Program agreed to update their Policy Manual, and used the policy manual of a nearby Tribal Program as its guide. 5. Identified systemic issues to be addressed in future: a. Use of Work Strides to deny VR services. b. Lack of trial work evaluations prior to placement on the wait list. c. IDVR transition services — VR counselor may attend IEP meeting, but will not initiate plan until nearing graduation. d. Lack of written plans for ICBVI and ILC clients. e. Provision of services to non-English speaking clients of the ILC programs.

j. Interesting Cases:

1. CAP was contacted by a 56 year old Caucasian male with blindness requesting assistance with filing a complaint against an independent living center regarding their new taxi voucher system, which was not accessible to people with visual problems.

The previous voucher system allowed taxi drivers to punch holes in the voucher to let people know how many trips they had left. In early 2014, the independent living center switched to a new system that did not allow for the hole punching, leaving people with visual problems without any means to verify how many trips they used, or had left. The client brought his concerns to the attention of an ILC staff person, and was told to not use the vouchers if he did not like them.

He contacted the CAP, who spoke with ILC staff and eventually the Executive Director about the issue. The ILC agreed that without a hole punch or other equivalent means to inform clients with visual impairments of their vouchers, they were left at the mercy of taxi drivers to accurately report their fees. The hole punch system was reinstated for the client, as well as other ILC clients with visual impairments, or who requested the hole punches as accommodations.

2. A 57 year old Native American female with multiple sclerosis and rheumatoid arthritis contacted the CAP initially for assistance to get VR services to train her service dog, which is a barrier to employment. Upon further conversation with the client, it became apparent there were additional issues with VR services, including a refusal to provide re-training/college courses because the client was already trained as an RN (could not continue as a nurse due to progression of her MS); client did not know if she had a plan for employment, and if so, what employment goal or services were listed; IDVR’s alleged refusal to provide a computer for college classes; and problems communicating with her VRC, who she alleged frequently laughed at her questions and missed appointments.

CAP requested copies of her IDVR records, care providers, and had many conversations with the client. It became apparent that client frequently changed her mind regarding her IPE goal, as well as the service she requested; however, it also became equally apparent that her VRC merely changed the IPE to appease her, without any evaluations or vocational counseling occurring to determine whether goals were appropriate given client’s functional and mental limitations. VRC admitted this but was unsure how to “change things.” The CAP advocate also noted in the medical information that client had a significant visual impairment that was not mentioned in any accommodations or assessments by IDVR.

CAP requested informal review on client’s behalf and discussed the issues, the outcome of which was the client should apply for services through the Idaho Commission for the Blind and Visually Impaired, given her difficulties with IDVR and the better fit regarding her primary disabling condition. The CAP Advocate also provided some recommendations and strategies in self advocacy to the client, including providing a better understanding of the IDVR system, the need to maintain open communication, and a consistent plan. Client was found eligible for ICBVI services, received her requested equipment, and will continue to receive limited services from IDVR. She is currently successfully working towards her employment goal.

3. A 47 year old Caucasian female with mental illness contacted the CAP for assistance with IDVR’s denial of private school tuition for a specialized program in favor of a program at the public university.

CAP spoke with client and her IDVR counselor, who indicated prior to payment for anything other than a computer and printer, his regional manager suggested client work part time as a physical therapist. He was unsure why the recommendation was made. CAP reviewed specific numbers with the client, which the VRC had not done, nor were specific numbers/costs detailed in the plan for employment. Client was informed that IDVR could pay up to 90% of the in state public university tuition rate for her private program, but she would have to pay the rest. She was aware of this, and apparently, this was what she was asking for.

The CAP advocate arranged a meeting with the VRC and the client to discuss all issues. The client advocated for herself with CAP support for the private program, outlining the information she had reviewed with CAP, including detailed breakdown of the tuition costs, the calculations for tuition payment by IDVR (at the 90% public university rate), and the degree requirements for the program. She also provided the VRC with information from the private university’s disability services, which she had already contacted and determined what supports were available.

The VRC provided the information to the Regional Manager, who approved the plan for employment with the private college program. CAP spoke with the Regional Manager, who assured us that issues with adequate vocational counseling as well as ensuring essential details are included in the plan for employment would be addressed with the IDVR counselor. The client has been enrolled since January of 2014 and is successfully working towards her degree in kinesiology.

k. Online Information and Outreach:

The P&A maintains a website, which typically includes substantial CAP information; however, this website has been under construction for most of this fiscal year. Basic information is still available, including information about the P&A and links to other resources, but has not been updated since the start of the fiscal year. A new website will be constructed and made available during the next fiscal year. Website hits: 7,204 Facebook average daily reach: 26/day; average daily reach per post: 34/day; “Likes”/”Follow”: 661 Blog annual hits: Approximately 2304 (192/month average) CAP Client Satisfaction Surveys returned: 2 (Responses: “Very Satisfied”)

Certification

Approved

This Report is Complete and Correct.Yes
Date Signed:08-Dec-14
Name of Designated Agency Official:James R. Baugh
Title of Designated Agency Official:Executive Director